Criteria for optimal electrical resynchronization derived from multipolar leads or multiple electrodes during biventricular pacing
AssigneeMedtronic, Inc.
InventorsSubham Ghosh, Robert W. Stadler
Life of this patent
Estimating the term…
Abstract
Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes. Pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses.
Claims53
A method of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes, comprising:
- a) pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes;
- b) pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes;
- and
- c) employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses,
- d) wherein selection of the one of the left ventricular electrodes for delivery of subsequent pacing pulses is determined through a weighted electrical dyssynchrony equation (“(ED (j, A, D)”) defined as:
- ED(j,A,D)=Σi=1nw(i,j)AT(i,A,D)
- wherein factor w(i, j) is a distance of a sensing electrode i from a pacing electrode j, n is a total number of left ventricular electrodes, A is atrio-ventricular delay, and D is time delay between pacing pulses in a right ventricle and a left ventricle.
A non-transitory machine readable medium containing executable computer program instructions which when executed by a data processing system cause the system to perform a method of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes, comprising:
- a) pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes;
- b) pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes;
- and
- c) employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses,
- d) wherein selection of the one of the left ventricular electrodes for delivery of subsequent pacing pulses is determined through a weighted electrical dyssynchrony equation (“(ED (j, A, D)”) defined as:
- ED(j,A,D)=Σi=1nw(i,j)AT(i,A,D)
- wherein factor w(i, j) is a distance of a sensing electrode i from a pacing electrode j, n is a total number of left ventricular electrodes, A is atrio-ventricular delay, and D is time delay between pacing pulses in a right ventricle and a left ventricle.
A system of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes, comprising:
- a) means for pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes;
- b) means for pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes;
- and
- c) means for employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses,
- d) wherein selection of the one of the left ventricular electrodes for delivery of subsequent pacing pulses is determined through a weighted electrical dyssynchrony equation (“(ED (j, A, D)”) defined as:
- ED(j,A,D)=Σi=1nw(i,j)AT(i,A,D)
- wherein factor w(i, j) is a distance of a sensing electrode i from a pacing electrode j, n is a total number of left ventricular electrodes, A is atrio-ventricular delay, and D is time delay between pacing pulses in a right ventricle and a left ventricle.
A cardiac pacing system comprising:
- a processor;
- a pulse generator coupled to the processor;
- a right ventricular electrode and a plurality of left ventricular electrodes spatially separated from one another and all coupled to the pulse generator;
- the processor configured to signal the pulse generator to generate pacing pulses to the right ventricular electrode and a first one of the left ventricular electrodes while activation times are measured at other ones of the left ventricular electrodes;
- the processor configured to signal the pulse generator to generate pacing pulses to the right ventricular electrode and a second one of the left ventricular electrodes while activation times are measured at other ones of the left ventricular electrodes;
- and
- the processor configured to employ sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses,
- d) wherein selection of the one of the left ventricular electrodes for delivery of subsequent pacing pulses is determined through a weighted electrical dyssynchrony equation (“(ED (j, A, D)”) defined as:
- ED(j,A,D)=Σi=1nw(i,j)AT(i,A,D)
- wherein factor w(i, j) is a distance of a sensing electrode i from a pacing electrode j, n is a total number of left ventricular electrodes, A is atrio-ventricular delay, and D is time delay between pacing pulses in a right ventricle and a left ventricle.
Dependencies are inferred from the claim text.